GLP-1 & incretin

Lixisenatide

A once-daily GLP-1 receptor agonist approved for type 2 diabetes, often paired with basal insulin.

Strong evidenceApproved drugAdd to compare

What it is

Lixisenatide is a once-daily GLP-1 receptor agonist built from exendin-4 with a short added tail that helps it resist breakdown. It is licensed for type 2 diabetes in the EU (Lyxumia) and the US (Adlyxin), and in practice is often added when basal insulin alone is not enough.

How it works

1
Activates GLP-1 receptors on pancreatic beta cells, raising glucose-dependent insulin release.
2
Suppresses glucagon after meals.
3
Slows gastric emptying, which is the main driver of its effect on post-meal glucose.
4
Reduces appetite through central GLP-1 signalling.
5
The added tail stabilises the peptide against DPP-4, allowing once-daily dosing.

What it's studied for

Type 2 diabetes as add-on therapy (GetGoal programme)

Cardiovascular safety in high-risk type 2 diabetes (ELIXA)

Combination with basal insulin

Postprandial glucose control

Weight as a secondary endpoint

Reported and studied effects

HbA1c reductions of roughly 0.5 to 0.9 percentage points
Marked reduction in post-meal glucose excursions
Modest weight loss
ELIXA found no cardiovascular harm and no clear benefit
More gastrointestinal effects than long-acting GLP-1 agonists

Research protocol notes

Research context only

Research context only - prescription medicine. Labelled dosing is 10 micrograms subcutaneously once daily for 14 days, then 20 micrograms once daily, injected within an hour before the first meal of the day; ELIXA followed participants for a median of 25 months.

These figures are described so you can understand what researchers did. They are not a dose, a schedule, or a suggestion — and they are not a substitute for a doctor.

Possible side effects and contraindications

Safety profile

Possible side effects

Nausea and vomiting, more common with rapid dose escalation
Diarrhoea
Headache and dizziness
Hypoglycaemia when combined with insulin or a sulfonylurea
Pancreatitis (rare)
Injection-site reactions

Contraindications and cautions

Personal or family history of medullary thyroid carcinoma or MEN2 (per US labelling)
Pregnancy
Prior serious hypersensitivity
Severe gastroparesis warrants specialist assessment

A side-effect list is never complete, and these are not the only situations that warrant caution. Anything unexpected, or anything you are unsure about, should be discussed with a doctor before use.

Evidence assessment

Strong evidenceReplicated, large human trials

Replicated, large human trials

The GetGoal randomised programme plus ELIXA, a cardiovascular outcome trial in over 6,000 people with recent acute coronary syndrome.

References

References link to published literature, regulator pages or literature indexes. Where a link points to a search, it collects the peer-reviewed work on that molecule rather than a single study.

Compare Lixisenatide with another peptide →

Related peptides

Other entries in GLP-1 & incretin.

All GLP-1 & incretin peptides →

GLP-1 & incretin

Cagrilintide

A long-acting amylin analogue that slows digestion and reduces appetite, studied alone and combined with semaglutide for obesity.

Moderate evidenceInvestigational

GLP-1 & incretin

Dulaglutide

A once-weekly GLP-1 receptor agonist approved for type 2 diabetes, with proven cardiovascular benefit in people at high risk.

Strong evidenceApproved drug

GLP-1 & incretin

Exenatide

A GLP-1 receptor agonist derived from Gila monster saliva, approved for type 2 diabetes in twice-daily and once-weekly forms.

Strong evidenceApproved drug